Depression is a serious condition that can impact many areas of a person’s life. Because there are many factors that can contribute to major depressive disorder, treatment approaches can vary, so there is no single way to treat it. Because there is no “one-size-fits-all” treatment, your individual experience may vary. However, there are certain things that you can expect in terms of how you will begin treatment, the approaches your doctor might recommend, and the results you might experience.
Here are some of the effects you can expect during major depressive disorder treatment.
How to Start Treatment
治疗通常从您看到有关可能的医生时开始symptoms of depressionthat you may be experiencing. Such symptoms can include changes in:
- 心情(绝望,冷漠,悲伤)
- Behaviors (irritability, crying, isolation)
- Cognition (poor concentration, trouble focusing, negative thoughts)
- Sleep (insomnia, excessive sleepiness, difficulty falling or staying asleep)
Your primary care physician may diagnose you and or refer you to a psychiatrist or other mental health professional.
Your doctor will ask you questions about your symptoms including what type of symptoms you have, how long you have had them, and how severe they are. In addition to assessing your symptoms, your doctor will also explore possible physiological factors that might contribute to depression.
Survey findingsby the National Institutes of Mental Health (NIMH) found that 17.3 million U.S. adults (or about 7.1 percent of the population) experienced depression in 2017.
What Happens After You Are Diagnosed
After you are diagnosed with major depressive disorder, there are a few different things that can happen. The right one for you may depend upon your symptoms and what your doctor thinks is causing your depression.
Ruling Out Medical Causes
Your doctor may start by addressing any underlying conditions that might be a factor. Chronic illnesses, thyroid conditions, certain medications, and substance use can cause or contribute to symptoms of depression.
Hypothyroidism, or underactive thyroid, can be a common medical cause that contributes to depression, particularly among women. If blood tests reveal that you have hypothyroidism, your doctor may prescribe medications designed to treat the thyroid condition, which may help alleviate depressive symptoms.
Once any underlying conditions have been addressed, your doctor may then:
- Prescribe an antidepressant.Antidepressantswork by balancing the chemicals in your brain called neurotransmitters. These neurotransmitters, which include serotonin, dopamine, and norepinephrine, have an effect on emotions and moods.
- Refer you to a mental health professionalsuch as a psychiatrist, psychologist, or counselor.抑郁症的心理治疗can include a range of techniques including talk therapy, cognitive-behavioral therapy, interpersonal therapy, psychodynamic therapy, and individual counseling. Talk therapy involves discussing issues that contribute to your depression symptoms.Cognitive-behavioral therapyfocuses on the underlying negative thought patterns that contribute to symptoms of depression.
Depression Discussion Guide
Get our printable guide to help you ask the right questions at your next doctor's appointment.
Researchhas found that psychotherapy is about as effective as antidepressants in treating depression. However, the effects of antidepressants stop fairly quickly once use is discontinued. The effects of psychotherapy, on the other hand, are usually longer-lasting.
在许多情况下,您的治疗将涉及抗抑郁药物和心理治疗的组合。
How to Know If Treatment Is Working
Once you begin treatment, you may notice some effects fairly quickly, although it may take time to find the medication and treatment approach that is right for you.
What to Expect From Antidepressants
If you are taking antidepressants, you may begin to experience some benefits fairly quickly, but most people will not begin feeling the full impact until several weeks after beginning the medication.
In addition to treating your symptoms of depression, however, you may also experienceside effects, which can vary depending upon the type of antidepressant you are taking. Some common side effects of antidepressants include dry mouth, sexual side effects, nausea, insomnia, restlessness, weight gain, headaches, and constipation.
While side effects such as these are usually manageable, you should still inform your doctor if you do experience any of these.
并非所有的抗抑郁药都适合每个人,并且您可能需要调整您的剂量或甚至尝试不同类型的药物。有时可能似乎令人沮丧或缓慢,但仔细监测你的进步和症状可以帮助确保您为您的需求接受最佳处理。
If you do not begin to notice any positive changes in your symptoms after six to eight weeks, talk to your doctor. In most cases, your doctor or psychiatrist may want you to continue to take a specific medication for a while in order for it to reach its full effectiveness. However, if you are not seeing any results, it is worth consulting your doctor to discuss changing your dose, switching antidepressants, or trying another approach.
Anyone taking antidepressants should be monitored carefully, particularly during the first few weeks of treatment. People may sometimes experience a worsening of symptoms or may start to havesuicidal thoughts.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat1-800-273-8255用于培训辅导员的支持和援助。如果您或亲人在立即危险,请致电911。
For more mental health resources, see ourNational Helpline Database.
Never stop taking your antidepressant without talking to your doctor. Suddenly stopping your medication can make your symptoms worse, so it is important to develop a plan with your doctor to gradually lower your dosage and allow your body to readjust.
What to Expect From Psychotherapy
心理治疗侧重于帮助人们了解可以有助于主要抑郁症的症状的思想,行为和情感。当您正在进行心理治疗时,您可能会经历的一些治疗效果在很大程度上依赖于您的个性症状和所使用的具体技术。
How It Helps
无论使用什么样的方法,都可以帮助您更好地处理可能导致您抑郁症感受的一些因素。这是其中的重要组成部分包括恢复消极思维,改善您的关系,管理压力,并寻找处理生活问题的新方法。
You will likely begin a regular treatment schedule that involves meeting with your therapist once or twice a week, depending on your needs. Just as with medication-based approaches to depression treatment, psychotherapy takes time. However, your therapist can also help you develop new coping skills that will help you to manage your stress, deal with negative thoughts and emotions, and manage your fears. Such skills can be particularly helpful as you wait for antidepressant treatments to begin working.
你可能不会开始感到任何重大积极的results from psychotherapy for several weeks and treatment may last for several months or even a year or longer. You will work with your therapist to determine when you feel that it is time to stop treatment.
Psychotherapy alone is not recommended for people with severe depression. Symptoms of severe depression include thoughts or plans of suicide, psychosis, impairments in basic functioning, and poor judgment that may result in self-harm. Patients with such symptoms should see a psychiatrist and may require hospitalization.
Changes to Expect
您可以期望在重大抑郁障碍治疗期间经历的变化包括:
- Improvements in mood
- 减少负面思想
- More motivation
- Feeling better able to handle stress
- Improved ability to cope with daily living
- Decreases in feelings of sadness or hopelessness
- Less irritability
- More interest in activities you previously enjoyed
- Improved sleep
- Less anxiety
Even if you are noticing improvements in your depressive symptoms, it is important to keep an eye out for signs of relapse. Talk to your doctor or therapist if you notice that your depressive symptoms are returning or worsening at any point during your treatment.
When to Ask for Additional Help
如果您没有注意到症状的任何改善,或者它们似乎变得更糟,请与您的医生或精神科医生交谈。有许多其他选择可用于耐治疗抑郁症,包括:
- Electroconvulsive therapy (ECT):ECT的使用是精神病学中的争议的来源,但它已经存在表明是有效的在里面treatment of depression. In this process, patients are placed under general anesthesia. Then, a small and painless electrical current is delivered to the brain. This causes a brief seizure which can help relieve depressive symptoms. Patients typically receive ECT in sessions over a period of a few weeks. People may feel relief from their symptoms fairly quickly, but they may also experience side effects including memory loss, confusion, headaches, and nausea.
- Vagus nerve stimulation (VNS):这涉及一种手术程序来植入一种设备,该装置将电信号发送到迷走神经作为改善情绪的方法。
- Deep brain stimulation (DBS):DBS involves implanting electrodes in areas of the brain associated with emotion. Side effects and risks include bleeding, nausea, breathing problems, seizures, and stroke.
- Repetitive transcranial magnetic stimulation (rTMS):这涉及将设备放置在颅骨上以将磁波传递到大脑的特定区域中。患者在这些会议期间留下醒来,并且不会经历任何痛苦。
ECT和其他类型的脑刺激通常仅用于患有药物和心理治疗的患者。
其他Steps You Can Take
Making lifestyle changes is an important part of treating major depressive disorder. There are a number of things that you can do to help supplement your treatment and find relief. Some of these changes can help alleviate symptoms in the short-term and aid in your long-term recovery.
Exercise May Be Helpful
Research has shown that regular physical activity can not only help prevent depression, it can also help alleviate symptoms. The idea that exercise may actually help treat depressive symptoms has been the subject of debate, but some evidence suggests that the beneficial effects may have actually been underestimated.
Ameta-analysis of the researchconcluded that exercise has a large and significant beneficial effect on depression (including major depressive disorder), supporting the idea that exercise is an evidence-based depression treatment.
Stick to a Schedule
It can also be helpful to resume some of the activities that you enjoyed before you began experiencing symptoms of depression. Depression can not only cause you to lose interest in the things you used to be passionate about; it can also make it difficult to stay on top of daily chores like doing the dishes or laundry. Seeing these things pile up makes it even more difficult to feel upbeat and motivated.
So when you are trying to manage your symptoms, focus on doing small things each day that will help restore your routines and sense of normalcy. If you have fallen out of a routine, create some sort of schedule that provides structure in your day.
Get Enough Sleep
Insomnia and other sleep disturbances are common symptoms of depression. Antidepressants may help with those symptoms, but you may also want to try relaxation techniques or have your doctor prescribe a medication to help with your sleeping difficulties.
Researchhas shownthat sleep disturbances are a risk factor for depression. Insomnia also increases the duration and severity of depression and makes relapse more likely.
A Word From Verywell
除了做这些事物外,您还是将您的药物作为规定的药物,与您的医生或治疗师进行沟通,了解您的感受,并为您的治疗时间提供工作。
Major depressive disorder is a serious condition, but it is treatable. It may take some time to find the right approach for your needs, but understanding what you can expect in terms of treatment effects can help you better recognize how your treatment is working.